{
  "abstract": "The 2025 EULAR recommendations for the management of systemic lupus erythematosus (SLE) with kidney involvement followed the EULAR standardized operating procedures, by recruiting an international Task Force of experts and performing systematic literature reviews (01/2019–03/2024), followed by modified Delphi method to reach consensus. The result led to four overarching principles and 13 recommendations, which were also evaluated for their feasibility and impact on clinical care. A kidney biopsy remains indispensable for any patient with SLE with evidence of kidney involvement. Treatment should aim for optimization (preservation or improvement) of kidney function within 3 months, accompanied by gradual reductions in proteinuria to a UPCR target below 700 mg/g by 12 months, and as low as possible afterwards. Combination therapy is recommended for patients with active lupus nephritis, especially those with poor prognostic factors: recommended combinations include: i) mycophenolate or low-dose intravenous cyclophosphamide with belimumab, or ii) mycophenolate with a calcineurin inhibitor (voclosporin or tacrolimus), or iii) mycophenolate with obinutuzumab. Following renal response, treatment should continue for at least three years, based on the initial regimen. For patients in sustained remission, immunosuppressive and/or biologic therapy can be considered after 3 years of therapy following response; risk for flare should be taken into consideration. A repeat kidney biopsy should be considered in all cases of clinical uncertainty, to evaluate i) response to treatment, ii) worsening of kidney-specific laboratory tests, or iii) if withdrawal of immunosuppressive treatment is contemplated in patients who are in sustained remission. Finally, management of kidney involvement in SLE also encompasses non-immune, nephroprotective treatment for avoidance of progression to chronic kidney disease and kidney failure, with renin-angiotensin-aldosterone blockade, sodium-glucose transporter 2 inhibitors (in selected, stable patients), cardiovascular and bone-protective measures.Learning Objectives At the end of this presentation participants will be able to:Discuss the updated EULAR recommendations for the management of SLE with kidney involvementDescribe the main combination treatments currently recommended for the management of SLE with kidney involvementExplain that the management of LN entails two equally important pillars: immunosuppressive treatment and nephroprotective measures",
  "authors": [
    {
      "affiliations": [
        "National and Kapodistrian University of Athens, Greece"
      ],
      "name": "Antonis Fanouriakis"
    }
  ],
  "title": "02 EULAR recommendations for lupus nephritis",
  "uid": "436510a9-577e-501c-a354-ccbc78579ee0"
}